新诊断的AML和超白细胞瘤的患者的结果
Fadi G Haddad1, Koji Sasaki1, Jayastu Senapati1
1Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX.
JCO oncology practice
|July 16, 2024
概括
在急性髓性白血病 (AML) 中,高白血细胞增多会导致早期死亡的高风险. 高龄,临床白血静止和血小板数量低是预测高白细胞计数的AML患者短期死亡率的关键因素.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 内部医学 内部医学
背景情况:
- 超白细胞症,定义为高白细胞 (WBC) 计数 (≥100 × 109/L),是急性髓性白血病 (AML) 的关键并发症.
- 这种情况与显著的发病率和死亡率有关,通常是由于白血静止症和其他并发症.
研究的目的:
- 为了确定与AML患者的早期死亡率和整体存活率 (OS) 相关的因素,这些患者呈现出高白细胞化.
- 为旨在改善这一高风险患者群体的治疗结果的管理策略提供信息.
主要方法:
- 从2010年1月到2020年4月,对129名新诊断的AML患者的WBC≥100 × 109/L的回顾性分析.
- 使用后勤回归和Cox比例危险模型来评估4周死亡率和生存率的预测指标.
主要成果:
- 平均年龄为65岁,中位数WBC为146 × 10 9 / L. 临床白血静止症 (CL) 在58%的患者中存在.
- 4周死亡率的独立预测因素包括年龄较大,CL和血小板缩<40 × 109/L.
- 与更糟糕的生存状况相关的因素包括年龄,CL,瘤溶解综合征,升高的LDH,升高的乳酸和低风险细胞遗传学. 平均生存期为14.3个月.
结论:
- 在AML的超白细胞瘤是医疗紧急情况,需要立即干预.
- 早期识别和管理,包括细胞减少,血液产品支持,抗生素和支持性护理,对于减轻风险和改善生存至关重要.
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